腰椎间盘突出症中椎间盘切除术与sequestrectomy术临床疗效的meta分析

发布时间：2019-01-07 12:42

【摘要】：目的：通过系统文献查询及meta分析的手段对腰椎间盘突出症中椎间盘切除术与sequestrectomy术的临床疗效及并发症进行比较。方法：系统搜索PubMed, Medline, Embase以及Cochrane图书馆中2014年6月1日之前的有关文献,经过筛选后确定入组文献。对入组文献中报道的患者基础情况、围术期指标、并发症、再突出率已经术后功能指标进行提取,并通过meta分析得出结论。结果：共12篇文献入组,其中1篇随机对照临床试验,5篇前瞻性对照研究,6篇回顾性对照研究。与椎间盘切除术相比,sequestrectomy术的手术时间较短(p0.001),术后腰背部疼痛评分较低(p0.05),止痛药应用较少(p0.05),病人满意度更高(p0.05),这些差异具有统计学意义。而再突出率、再手术率、术中出血量、住院时间、坐骨神经痛评分无显著差异。结论：我们的meta结果显示,与椎间盘切除术相比,sequestrectomy术后腰背部疼痛更轻,病人满意度更高,但是再突出率及并发症无明显差异。该结论尚需高质量的大规模随机对照临床试验进一步验证。
[Abstract]:Objective: to compare the clinical effects and complications of discectomy and sequestrectomy in lumbar disc herniation by means of systematic literature query and meta analysis. Methods: the relevant documents before June 1, 2014 in PubMed, Medline, Embase and Cochrane libraries were systematically searched and selected. The basic condition, perioperative index, complication and reherniation rate of the patients reported in the literature were extracted, and the conclusion was obtained by meta analysis. Results: one randomized controlled clinical trial, five prospective controlled trials and six retrospective controlled studies were included. Compared with discectomy, sequestrectomy had shorter operation time (p0. 001), lower back pain score (p0. 05), less use of painkillers (p0. 05), and higher patient satisfaction (p0. 05). These differences are statistically significant. There was no significant difference in reprotruding rate, reoperation rate, intraoperative bleeding volume, hospitalization time and sciatica score. Conclusion: compared with discectomy, sequestrectomy has less pain and higher patient satisfaction than discectomy, but there is no significant difference in reherniation rate and complications. This conclusion needs to be further verified in a large-scale randomized controlled clinical trial.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

【共引文献】